Nikhil Sethi presents a case using dental lasers to perform a gingivectomy on a primary upper left canine.
Nik Sethi qualified from King's College London in 2009. He has a Master of Science degree in aesthetic dentistry, and also at King's College London. Since then, he has established himself at a private practice in London and has developed a keen interest for restorative treatment and endodontics.
Nik has attended several highly respected courses on restorative dental training, including a one year course with Tidu Mankoo and Basil Mizrahi. He is also on the executive council of the British Academy of Aesthetic Dentistry and a full member. Nik provides regular teaching courses on composite restorations and is regularly featured in Dentistry Magazine, writing a series of articles aimed at educating younger dentists.
Lasers in dentistry can be divided into two main types: soft tissue lasers and hard tissue lasers. The laser used in this case is the Gemini 810 + 980 diode laser by Ultradent. The main use of the laser in this case was to scallop the gingival margin of a primary canine to match the contralateral adult canine. It was also a valuable tool for providing haemostasis for the resulting composite addition to the cervical area.
Gemini Case Presentation
A 42-year-old gentleman, attended the practice with a primary upper left canine which had undergone significant cervical wear. Despite the number of years the primary tooth had been present, it was not mobile, and therefore there was no reason to replace it. The patient was not happy with the colour of his tooth, and the difference in gum height compared to the contralateral Permanent canine.
After bone sounding, it was determined that the cervical margin could be relocated 1.5mm apically without risk of encroaching the biological width. The treatment plan was ordered to correct the gingival discrepancy, and then restore the tooth with composite resin to camouflage; giving the appearance of a permanent canine. It was also decided at the following visit, that composites on the central incisors would be refaced, as the colour match was not ideal.
Using the Gemini laser in gingivectomy mode, the gingival margin was carefully scalloped 1.5mm apically following a similar gingival scallop of the adjacent teeth.
This was extremely quick and effective with the added benefit of rapid haemostasis and creation of a coagulum which reduced the risk of gingival crevicular fluid contaminating the field of isolation.
Isolation gingival was reinforced by using some ultra pak retraction cord triple 0. After sand blasting and following a self-etching adhesive protocol (after enamel selective etching and rinsing) the tooth was then restored, producing a camouflage effect, copying the right permanent canine.
6 Month Review
At the six-month review, excellent gingival symmetry and acceptable aesthetics were achieved. It was observed that the canine was far more similar to the contralateral tooth. Additionally, the black triangle situation was improved by moving the contact point on the central incisor composite additions (using the principles of Tarnow et al).
A primary observation of interest was the rapid response of healing following use of the Gemini laser. In an incredibly short space of time, the patient showed remarkable change. In summary, the Gemini laser was the perfect tool for scalloping the gingival margin with precision, accelerating healing with the added benefit of rapid haemostasis.
About the Gemini Laser:
No matter the procedure, the innovative Gemini laser makes it faster, smoother, and more efficient. As dentistry's first dual-wavelength soft tissue diode laser, it is truly one of a kind. For ease of use, the Gemini features 19 preset procedures that automatically adjust the laser settings to provide the most effective power and pulse settings for common procedures.
Furthermore, the Gemini features an electroluminescent display and sleek illuminated handpiece, which also features the convenience of pre-initiated tips, further setting this powerful unit apart as the next generation of soft tissue diode lasers.
Dual Wavelengths - One of a Kind
The Gemini laser promises professional development for the clinician, optimised ROI for the dental practice, and increased patient comfort.
Why not arrange a practice visit with our product specialists who will be happy to demonstrate how lasers will reinvent your daily dentistry. Simply click here to request your free laser demo today!
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